Risankizumab (Skyrizi Injection) is a humanized monoclonal antibody that inhibits the binding of IL-23 to its receptor resulting in the inhibition of pro-inflammatory cytokines.

Risankizumab (Skyrizi) Uses:

• Moderate to Severe Plaque Psoriasis:

  • It is indicated for the treatment of adults with moderate to severe plaque psoriasis who are candidates for phototherapy or systemic therapy.

Read: Biologics for Psoriasis

Risankizumab (Skyrizi) Dose in Adults

Risankizumab (Skyrizi) Dose in the treatment of moderate to severe plaque psoriasis:

• 150 mg as two 75 mg injections are administered as two consecutive injections at different sites subQ.
• The dose is administered at weeks 0, 4, and every 12 weeks thereafter.

Risankizumab Use in children:

It has not been studied in children.

Risankizumab Pregnancy Risk Category: Not assigned

• It can also enter the fetal circulation, just like other endogenous IgG. 
• It is also dependent on the IgG class and the gestational year. With increasing gestational years, more is transferred through placenta.

Use during breastfeeding:

• It is unknown if the drug will be excreted into breastmilk.
• Breastmilk contains endogenous IgG, which can lead to drug exposure in infants.
• Manufacturers recommend weighing the risks to the infant and the benefits for the mother during therapy.

Dose in Renal disease:

• It has not been studied in renal disease.
• The manufacturer has not recommended any dose adjustment in renal disease.

Dose in liver disease:

• It has not been studied in liver disease.
• The manufacturer has not recommended any dose adjustment in liver disease.

Common Side Effects of Risankizumab (Skyrizi):

• Immunologic:

  • Antibody Development

• Infection:

  • Infection

• Respiratory:

  • Upper Respiratory Tract Infection

Less Common Side Effects Of Risankizumab:

• Central Nervous System:

  • Headache
  • Fatigue

• Dermatologic:

  • Tinea

• Local:

  • Injection Site Reaction

Uncommon side effects of Risankizumab (Skyrizi):

• Neuromuscular & Skeletal:

  • Asthenia

• Respiratory:

  • Nasopharyngitis
  • Pneumonia
  • Rhinitis
  • Sinusitis
  • Tonsillitis

Contraindications to Risankizumab (Skyrizi):

Hypersensitivity reactions to any component of the drug or the drug itself.

Warnings and precautions

• Infections

  • Risankizumab has an increased chance of infection.
  • Clinical studies show that upper respiratory tract infections and tinea infections are more common in the clinic.
  • It is important to withhold treatment until the active infection has been treated. Patients with a history or chronic recurrent infection should weigh the benefits and risks of treatment.
  • Monitor patients for signs and symptoms of infection. Patients with fevers or other symptoms of infection should seek medical attention immediately.
  • Patients may have to stop receiving treatment if they develop serious infections or are unable to respond to treatment.

• Tuberculosis

  • Before beginning treatment, patients should be tested for tuberculosis.
  • Patients with active TB should not be treated. Those with latent tuberculosis should be initiated on anti-tuberculosis treatment prior to treatment with risankizumab.
  • Patients with a history of active tuberculosis or latent tuberculosis should consider anti-TB therapy. However, if TB treatment is not possible to confirm, the patient must be treated.
  • Patients should be monitored closely for signs and symptoms of active TB during risankizumab.

Risankizumab: Drug Interaction

Monitor:

• Monitor for the signs and symptoms of infections during and after the treatment including Tuberculosis.
• Patients should be screened for evidence of active or latent tuberculosis before initiating the treatment.

How to administer Risankizumab (Skyrizi)?

• It is administered as a SubQ injection under supervision by a healthcare professional.
• After proper training, self-injection may be allowed.
• It is administered into the anterior abdomen, thighs, or upper arm as two consecutive injections subcutaneously at two different anatomic locations.
• Injection into infected, bruised, inflamed, or skin affected by psoriasis should be avoided.

Mechanism of action of Risankizumab (Skyrizi):

• Risankizumab, a monoclonal humanized antibody of the IgG-1 class, binds to interleukin P19 and inhibits its binding to IL-23 receptors.
• This results in the inhibition of IL23-induced pro-inflammatory cytokines or chemokines.

Metabolism: It is broken down by the catabolic pathways, just like endogenous IgG to small peptides or amino acids. BioavailabilityAfter the SubQ administration, 89% Eliminating half-lifeIt takes approximately 28 days When to reach peak serum concentration: 3-14 days

International Brands of Risankizumab:

• Skyrizi (150 MG Dose)
• Skyrizi

Risankizumab brand names in Pakistan:

No Brands Available in Pakistan.